Scaphoid osteosynthesis: early experience with the Herbert bone screw

The results of our first fourteen patients with fractured scaphoids treated with the Herbert bone screw have been disappointing. Six have failed to unite. The operation is technically demanding and there is a high incidence of malpositioning of the screw which correlates with failure to achieve union. This is predictable from initial radiographs and peroperative radiology is advised. The osteosynthesis should be protected until union has occurred radiologically, especially in manual workers.